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Prediabetes: Prevention Tips for HIV Positive Patients

Table of Contents

  • Introduction
    • Why am I at greater risk?
    • Why do I have it?
    • What can I do about it?
  • Metformin (Glucophage)
    • What is it?
    • What are the benefits?
    • Are there side effects?
  • Meal Planning Made Simple
    • Focus on
    • Limit
  • Resources
    • American Diabetes Association – Recipes
    • The Body – The Complete AIDS/HIV Resource
    • USDA MyPlate – Recipes and Resources
    • Spark People – Recipes and Resources
    • Check your local health department or YMCA for diabetes prevention programs.
    • Looking for a registered dietitian in your area?

Editors

Brooke Butterworth, MS
2016-2017 Vanderbilt Dietetic Intern

Prediabetes is a condition in which blood sugar levels are elevated, but not high enough to be considered diabetes. There are no symptoms besides high blood sugar or an hgbA1C of between 5.7- 6.4%. If left untreated, prediabetes will develop into Type 2 diabetes.

    Why am I at greater risk?

    People with HIV are at greater risk of developing diabetes for a number of reasons including chronic inflammation, Hepatitis C infection, lipodystrophy, and taking certain types of HIV medications. In addition, Type 2 diabetes is a risk factor for other chronic conditions like heart disease

      Why do I have it?

      High blood sugars are typically a result of lifestyle factors, age, being overweight, or a family history of diabetes. The good news is that you can make small lifestyle changes, such as eating better, quitting smoking, and being more active, to prevent or delay developing diabetes.

        What can I do about it?

        • If you are overweight, a weight loss of just 5-7% of your body weight can decrease your risk and improve your cholesterol and triglyceride levels
        • Track what you are eating and drinking
        • Eat smaller portions and fewer calories
        • Eat a lower fat diet
        • Follow MyPlate
        • Physical activity has a number of health benefits including lowering your blood sugar, blood pressure, and cholesterol
        • Exercise is encouraged and safe for people with HIV
        • Be active 30 minutes a day
        • Try splitting the time into three 10 minute walks
        • Incorporate activity into daily life, like parking further away or taking the stairs

        What is it?

        In some cases, medication may be needed in combination with lifestyle changes and can be prescribed by your doctor. Metformin is a popular oral drug used for treating Type 2 diabetes that helps lower blood glucose levels by improving the way the body handles insulin and prevents the liver from making excess glucose.

          What are the benefits?

          Metformin not only lowers blood glucose levels, which in the long term reduces the risk of diabetic complications, but it also lowers blood cholesterol and triglyceride levels. It is less likely to cause weight gain the way insulin and some other oral bloodglucose- lowering drugs do.

            Are there side effects?

            The most common side effects of metformin are nausea and diarrhea, which usually go away over time. Dolutegravir (Tivicay) may increase the serum concentration of metformin. Your doctor might limit your metformin dose when used together with dolutegravir to help manage this interaction.

            Focus on: 

            • Whole grains
            • Lean proteins like fish, chicken, beans, and nuts
            • Low-fat and non-fat dairy
            • Half a plate of fruits and non-starchy vegetables
            • Healthy fats like nuts, avocado, and canola and olive oil

            Limit:

            • Sugary beverages and juices
            • Trans and saturated fats
            • Highly processed foods
            • Fried foods
            • Desserts